This letter is a convenient way to formally notify an insurer, agent, or individual that a claim for damages has been submitted. Includes spaces to describe the accident as well as date, time of day, and location.
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123 Main St. Anytown, CA 95928 (555) 555-1212
August 14, 2010
Andy Anderson 345 Any Place. Anytown, CA 95928
Dear Mr. Anderson:
This letter is to notify you of a claim submitted against you for damages as a result of the accident and/or injury described below. I believe that you or your agents/representatives are liable.
Accident description: Date: Time of Day: Location:
Please make sure that your insurance agent or attorney contacts me immediately, so that we can reach a speedy resolution. I can be reached via cell phone at (555) 555-1212.
Sincerely,
Danny Daniels
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This Printable Business Form Template belongs to these categories: medical
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